It seems that the hypertension ( HTN) seen by patients being treated with Ibrutinib continues to rise year on year with treatment.
At 5 years 74% of patients experienced an increase in Systolic Blood Pressure of ≥10 which is a huge number of patients. This hypertension is also often difficult to control well.
New HTN on ibrutinib was not associated with: tobacco use, obesity, chronic kidney disease or obstructive sleep apnea (p > 0.05).
"New HTN in patients on prolonged ibrutinib treatment is persistent, linear and independent of other risk factors. The increase in BP remained despite initiation of anti-HTN therapy. Additional studies are ongoing to define cardiovascular and renal complications associated with HTN in these patients"
I would certainly like to if I had the opportunity but I can't see a mechanism to do it in the NHS, especially for those of us in trials where the Ibrutinib is paid for.
I asked my Consultant that question after my BP suddenly went off the scale ( lucky to avoid a trip to A&E and now on medication ) he said if I was to switch it would be Venetoclax. I might keep asking, especially as I understand it’s a similar price.
I know what you mean. So far so good for me 3 years in 🤞. We all need to keep up to date with what next questions as the treatments are moving fast.Take care
I'd be interested to see the full paper and all the numbers, as well as the methods. Can't seem to be able to locate it. BP is such a fickle entity. But v important. Jig
Given that acalabrutinib appears to be as effective as Ibrutinib, with fewer side effects and at about the same cost, why is Ibrutinib still prescribed more often? What am I missing?
I think that will change, certainly in the UK due to a price difference as well as the patient benefits. Acalabrutinib has only just been approved in the UK by NICE
I think it’s so they have a number of treatments available. Try Ibrutinib first, if that creates issues move to another treatment. I am on Ibrutinib and after 6 months have zero side effects. I’m watching my BP though, I noticed the odd high reading lately.
It's often the case that the first-in-class hogs the market for longer than objectively it deserves. Ibrutinib sales last year topped $8 billion and will probably continue to rise for some while. Acalabrutinib has a lot of catching up to do.
Yes, interesting! I was on Ibrutinib for 6 yrs. before I became resistant to it. During the last couple years, I had pvc's and my blood pressure started going up and down. After starting on the ARQ trial, another BTK inhibitor, the pvc's and blood pressure have gradually settled down. On another note, some gut issues have faded also.
Exactly for that reason I was taking Acalabrutinib on compassionate basis, not in a trial. I was doing really well for 8 months and then I ended up with AF and crazy high BP, which took some doing to get under control by my cardiologist. I also ended with heart failure, unfortunately. Difficulty is, not knowing who will end up with these kinds of side effects and who will be sailing through treatment with no problems. I think it happens less often with Acalabrutinib, but the possibility is still there unfortunately. The time will show.
I wish, I could have stayed on it as there were very few side effects only, at the beginning, and I found it easy to take.
I am on Venetoclax now, starting Rituximab in two weeks. My BP is finally under control and my heart failure is monitored by my cardiologist and Heart Function Unit at the hospital.
I am not trying to scare anybody as I believe it is a very good drug and it has much less cardio side effects than Ibrutinib.
I’m finding all these post interesting if not a little scary. I’ve just finished all my pre treatment tests and should be starting in 2 weeks. My hospital has said I’ll be on one of the following three courses
Yes Jm954, a clinical trial. I have a symptom that has been accredited to my CLL that I haven’t read or seen on here yet. Both my thighs go numb which gradually eases to a touch of pins & needles type sensation. My left heal also goes numb. I’ve had tests carried out by 2 neologists who have put it down to the CLL.
Mayo Clinic mentioned CoQ10 as possibly useful to lower blood pressure. I started to take CoQ10 and unpasteurized, unfiltered, raw apple cider vinegar both at the same time, therefore I do not know which of the two or whether both lowered by blood pressure by 5 to 10 points.
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ASH 2018: Professor Peter Hillmen on the Combination of Ibrutinib and Obinutuzumab in CLL: Timing Matters
